FENESTRATED ANACONDA IMPLANTATION

Robin Williams Consultant Interventional Radiologist Freeman Hospital Newcastle-upon-Tyne

Disclosures • Proctor for Terumo Vascutek

79 man • 2010 infrarenal AAA, angulated prox. Neck

•  Medtronic Endurant EVAR no proximal seal T1EL •  Cook Zenith Cuff AAA excluded

• 2015 persistent AAA growth, loss of prox neck

•  Referral to Freeman Hospital •  Para-visceral aneurysm •  Angulated proximal neck (in two planes)

Anaconda fEVAR advantages • Reposition and collapse graft

•  Free access to graft from an upper body approach

• Virtually unlimited position of fenestrations

• Sequential stenting of fenestrations

Anaconda fEVAR results Number Mortality

Freedom

from type I/III endoleak

(30 day)

TVP (30 day)

TVP (late)

Freedom from AAA

growth (1yr)

fEVAR - NSQIP ~600 5.1% - -

Globalstar 318 4.1% 7.2% (procedural)

98.8% 95% (3yrs)

Anaconda Global registry

536 5.2% 95.7% 98.8% 98.5% (2 yrs) 95%

UK 4 centre study

101 3% 97% 98.6% 99.1% (1 yr) 100%

Freeman Hospital

39 2.5% 96.8% 100% 100% (1yr) 100%

Dutch Experience

25 4% 100% 96% - -